This article was authored by Deepa Kumaraiah, MD, MBA, assistant professor of medicine at Columbia University Medical Center and assistant chief medical officer at New York Presbyterian Hospital, and Lauren T. Wasson, MD, MPH, assistant professor of medicine at Columbia University Medical Center.

Ever-increasing numbers of women are pursuing careers as physicians, with women comprising nearly half of all medical school graduates in 2014. However, according to a 2009 ACC workforce survey, only 12 percent of all cardiologists are female. While men and women enter academic medicine in equal numbers, there are four times more male full professors. Much has been written on the topic of attrition of women in the pipeline towards competitive subspecialties and leadership positions. One factor is that as women enter lengthy training programs and dedicate themselves to rigorous medical careers, their professional trajectory can be affected by challenges not necessarily encountered by their male colleagues: fitting into their lives child-bearing, parental leave, breastfeeding and care-giving in the context of their career ambitions and demands. Introducing flexibility within the training/career path has been proposed as a solution. Here we believe we can take a lesson from corporate America – looking at face-to-face time in medicine and “Facetime” as a solution.

Face-time is critically important throughout many stages of an academic medical career as women work to establish themselves as engaged and dedicated providers, educators, researchers and colleagues. Physicians in internal medicine and associated specialties must fulfill rigid, nationally-recognized training requirements that allow only four weeks of leave per year for any reason. Taking leave for more than four weeks risks postponing training for one full year given the fellowship application schedule. Once in practice, academic physicians provide direct patient care, teach and supervise residents, and engage in research endeavors. Furthermore, academic careers place an unquantifiable premium on attending and participating in frequent conferences and on being available for impromptu conversations and consultations.

ACC’s Women in Cardiology Section should consider the many face-time demands placed on female cardiologists and determine which of these demands may in fact be more flexible and amenable to alternatives at points when family responsibilities may be heightened. There are many other professional fields that have embraced leave policies and technology solutions that medicine could adopt or model after. Cardiology training programs can consider requiring deliverables rather than strict time commitments for research time so that new mothers could extend their maternity leave beyond four weeks and achieve research goals flexibly from home. “Facetime” technology can be used as a teleconferencing solution to meet the face-time requirements of lectures and meetings. Finally, the use of telemedicine as a means of delivering patient care is expanding; incorporating flexible clinical time (e.g., video follow-up visits) is a solution that should be explored.  

Regardless of the method, these are solutions that require institutional support and physician buy-in to succeed. Policy and culture change can take time, but the investment would be worthwhile. Male and female physicians alike can benefit from even small improvements in face-time flexibility as they try to fit together and accomplish their professional and personal life goals and aspirations.